Dendritic cells in hematologic malignancies: a brief review of immunoregulation to new perspectives

Dendritic cells (DCs) are essential immune system sentinels, playing a key role in activating naïve T cells against leukemic cells. They have an immunomodulatory function, promoting an immune response and, at the same time, regulating immune tolerance to avoid excessive reactions. Plasmacytoid dendritic cell (pDC) neoplasms are a complex group of disorders, and among the subtypes, acute myeloid leukemia (AML) with pDC dermatosis (AML-pDC) stands out. In this context, pDCs can play an immunomodulatory role by inhibiting or promoting immune responses and acting as tumor progenitors since, in some cases, they can collaborate with the tumor microenvironment, favoring immune evasion and proliferation. However, the clinical significance of pDC in AML is not fully understood. Studies suggest that the interaction of pDCs with the leukemic microenvironment may contribute to disease progression by impairing the immune system's ability to control tumor cells. Understanding the role of DCs in neoplasia is crucial, as it provides important insights for new studies seeking advances in innovative therapeutic strategies, such as dendritic cell vaccines. These vaccines are promising, with low toxicity and the potential to improve the prognosis of individuals affected by AML, stimulating an effective immune response.